Predictors Of Response To Antidepressants: Utility Of Behavioural, Neuroimaging And Genetics Data
Funder
National Health and Medical Research Council
Funding Amount
$310,071.00
Summary
Major depressive disorder (MDD) is projected to cause the second greatest global burden of disease by 2020, highlighting the urgent need for valid predictors of effective treatment response. Currently, there are no accurate predictors of response to antidepressants in MDD, and successful treatment relies greatly on 'trial and error'. This process is demanding on health resources, and may be a factor in the high suicide rates in depressed patients. Previous research on treatment response has been ....Major depressive disorder (MDD) is projected to cause the second greatest global burden of disease by 2020, highlighting the urgent need for valid predictors of effective treatment response. Currently, there are no accurate predictors of response to antidepressants in MDD, and successful treatment relies greatly on 'trial and error'. This process is demanding on health resources, and may be a factor in the high suicide rates in depressed patients. Previous research on treatment response has been limited by recruitment of small, heterogeneous patient samples, lack of placebo control, and a failure to examine task related activity in brain imaging studies. Perhaps one of the more troubling aspects of research that aims to predict treatment response to antidepressant medications is the use of commonly used outcome measures such as the Hamilton Rating Depression Scale (HAM-D), which were developed long before current classification systems of depression came into use. The US Federal Drug Administration has recently identified what they call a translational gap such that behavioural and biological measures are the most robust for detection of disorders such as depression, yet these measures remain to be translated into clinical tools that can be used to evaluate treatment. The aim of the current study therefore is to determine whether genetic variability is related to treatment outcome as defined by a more objective outcome measure (facial expression perception) using a randomised controlled design. The study will also determine whether brain measures (fMRI, EEG) enhance the prediction of SSRI response to both clinical and behavioural measures, over and above the genetic contribution.Read moreRead less
The Diamond Cohort Study - Long Term Outcomes Of Depressive Symptoms In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$567,538.00
Summary
The diamond study follows what happens to almost 800 people with depressive symptoms whom attend general practice for care over 5 years of their life. This study will map the severity of depressive symptoms, life circumstances, use of health care services and treatments and allow us to understand factors associated with relapse and recovery from depression in order to improve care. This will assist us to develop models of care that better suit the needs of people experiencing depressive symptoms ....The diamond study follows what happens to almost 800 people with depressive symptoms whom attend general practice for care over 5 years of their life. This study will map the severity of depressive symptoms, life circumstances, use of health care services and treatments and allow us to understand factors associated with relapse and recovery from depression in order to improve care. This will assist us to develop models of care that better suit the needs of people experiencing depressive symptoms.Read moreRead less
The Validation Of A Culturally-specific Measure To Identify Depression In Aboriginal And Torres Strait Islander People With Or Without Chronic Disease
Funder
National Health and Medical Research Council
Funding Amount
$658,971.00
Summary
The project aims to determine whether a short, free-to-use, questionnaire about depression that has been adapted for use with Aboriginal and Torres Strait Islander people, accurately identifies depression in this population. Specifically we aim to test whether this measure is suitable for use in primary care settings with Aboriginal and Torres Strait Islander people with or without chronic disease.
The Burden And Risk Factors Of Depressive Disorders In Indigenous Australians: Implications For Early Detection And Prevention
Funder
National Health and Medical Research Council
Funding Amount
$318,768.00
Summary
This Fellowship addresses the high rates of depression amongst Indigenous Australians. The proposed work will quantify the extent to which two major risk factors contribute to the burden of depression in this population and the burden avertable from interventions to modify these risk factors. Findings would inform resource allocation and health service delivery, and in doing so, present opportunities for improvements in the health of Indigenous Australians.
The Role Of Non-classical MHC Class I Molecules In Adaptive Immunity
Funder
National Health and Medical Research Council
Funding Amount
$443,834.00
Summary
Specialised proteins called MHC class Ia molecules (MHC-Ia) stimulate killer T cells to lyse virus infected cells. In contrast, the function of the closely related MHC-Ib is uncertain. Recent findings have demonstrated that MHC-Ib can also be recognised by T cells and this interaction is important in the control of viral infections. However, despite the similarity to MHC-Ia, it is unclear how this interaction occurs. This project aims to investigate how killer T cells recognise MHC-Ib molecules.
The Unique Nature Of Gamma Delta T Cell Recognition Resolved Through Interaction With H2-Q10
Funder
National Health and Medical Research Council
Funding Amount
$699,031.00
Summary
The liver is important for both digestion and immunity. Given these opposing functions, the liver must exert control points that prevent the immune system from recognising food products. We have now identified a new molecular target that controls the development of immune cells in the liver.
Using Reward-based Biomarkers To Improve The Early Detection Of Bipolar Disorder In Individuals Seeking Treatment For Depression
Funder
National Health and Medical Research Council
Funding Amount
$366,252.00
Summary
Bipolar disorder is often misdiagnosed as unipolar major depression, which can have disastrous clinical consequences. Emerging evidence indicates that individuals with bipolar disorder show particular dysfunctions within brain regions involved in processing reward. This research will use cutting-edge neuroscience methodologies to investigate reward processing in these two disorders, with the objective of identifying biological markers that help distinguish bipolar from unipolar depression.
STudy Of Risk Assessment To Reduce Complications In Patients Following Noncardiac SurgerY (STRATIFY)
Funder
National Health and Medical Research Council
Funding Amount
$436,000.00
Summary
Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduce ....Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduces longterm risk. However, in many patients undergoing major noncardiac surgery, this approach may be inappropriately aggressive, as these patients are often elderly, have other diseases that make heart operations more difficult and risky than usual, and in any case may have a reduced life expectancy from the disease necessitating the operation. As the most critical issue is to ensure that patients undergo their surgery uneventfully, an alternative is the use of intensive medical therapy to protect the heart. This multicentre study, based at Brisbane hospitals that perform large numbers of major operations, will follow up patients for complications, and outcome (including quality of life) will be assessed six months after the operation. We will address two important questions about the efficacy and cost of risk reduction strategies. First, in patients at higher levels of risk and with a positive stress test, could a combination of medical therapy designed to protect the heart be as effective as current approaches, which include the performance of bypass surgery or coronary balloon angioplasty? Second, in patients identified as being at some risk - but low risk - are drugs sufficiently effective to avoid the need for further testing to quantify risk? As the population continues to age, the numbers of at risk patients undergoing major surgery will increase, and answers to these questions will provide important information to guide their management.Read moreRead less